Sometimes scary things happen to us. It can happen to us on an unknown path we take, or in a familiar place we love. When bad things happen to us, we start to question everything around us. We question why this happened to us. We question the validity and fairness of the world. The world becomes different. What are we suppose to do in a world that is no longer safe?

When bad things happen to us, our sense of security is under siege and our defense mechanism is on high alert. Even the nice warm summer wind we used to love can make the hairs on our back stand up. We guard ourselves tightly to the point we can no longer feel.

When bad things happen to us, we may question if there’s something we could have done differently. We desperately attempt to salvage the control we once had but lost. Our mind keeps replaying the fearful scenario that we no longer have room for joy. It’s hard to breathe; even the air feels heavy.

I understand because I have been there. I know therapy can help. With therapy, you can learn to breathe again, slow down the replay in the mind, learn to trust the world, and believe in yourself. You can move from “what was” to “what can be.”

It’s a Tuesday morning and you’re sitting at your desk. Your coffee is still hot, almost all of your emails from the previous day have been opened and you’re prepping for your afternoon meeting. Then, in a matter of minutes, a call from the school nurse comes through. Your child is sick and needs to be picked up immediately. As you coordinate those plans, the doctor’s office calls to remind you of your mother’s 2:30 pacemaker appointment for later that day, one that may have slipped your mind. If this scenario, in any variation of it, sounds familiar, you are in what researchers call the “Sandwich Generation.”

The Sandwich Generation can be defined as individuals aged 40 to 59 to who are responsible for raising children while caring for the needs of their parents. A study conducted by the Pew Research Center shows that roughly one out of every eight Americans falls within this category. I’m all too familiar with helping individuals, particularly women, handle the day to day stresses of being a dual caregiver. As women stuck in the Sandwich Generation, the dueling lifestyles can create a number of psychological, emotional and financial stresses. Here are a few:

Though men can be in the Sandwich Generation, families are more likely to adopt the “efficiency mentality.” This is the belief that since women are already taking care of children, taking care of aging parents may not seem as big a burden to add on. This mentality grossly underestimates the resources and time necessary to handle both responsibilities.

One major factor that has played a role in the steady growth of the Sandwich Generation is that many couples are delaying the point at which they choose to start a family. This is in large part due to the ever-changing economic climate and student loan debt. Women are working to become more established in their careers and financially secure before starting a family.

Single mothers are increasingly becoming the dominant demographic of the Sandwich Generation in comparison to married mothers.

Advances in the medical field have increased life expectancy, allowing aging parents the ability to live longer and healthier lives. This means more resources are necessary to sustain living. Societal expectations of women caregivers in conjunction with the economy driving women to work have created emotionally and psychologically draining ‘round-the-clock lifestyles for women within the Sandwich Generation.

It is very common for women in the Sandwich Generation to experience feelings of depression, anxiety and other symptoms of emotional distress because of worries about outlook for elderly parents, themselves and their own children.

The needs of the caregiver within the Sandwich Generation often go unaddressed, creating personal issues in areas such as health and finance.

Despite the negatives, it is possible for the Sandwich Generation to meet the demands of child, parent and self. This comes through support networks, communication, prioritization and respite care.

A positive that comes from Sandwich Generation is the familial bond created – strengthening the bond between elderly parent and adult children. Grandchildren get to know their roots by being with their grandparents more.

Planning, organization and communication are three main skills that help those women within the Sandwich Generation to balance the constant needs of both children and parents.

Are you in the Sandwich Generation? Share your issues, knowledge, struggles and suggestions below. Mabel Yiu is a licensed marriage and family therapist with Women’s Therapy Institute in Palo Alto, Calif.

We get it. This article gets your attention because your partner is suffering from depression or anxiety, or other mental illness. And you don’t know what to do about it. Mental illness drives a wedge into your relationship and family life. It’s not hopeless, here are a few things you can do now.

1) Don’t jump into “fix it” mode and offer “solutions”. We understand, your spouse is feeling depressed and you want to fix it quickly and move on. Maybe you feel helpless for not knowing what’s going on. Maybe you feel nervous that your spouse might harm him/herself. Going into “fix it” mode is more about easing your own anxiety and it’s not about your spouse. Your spouse isn’t stupid, he/she can feel it and he/she would instinctively put up a defensive wall which disconnects you two further. ”Fix it” mode only isolates your partner further.

2) Listen. Like take a deep breath and truly listen…even when it’s hard. A big part of mental illness is isolation. We humans are social animals, we are not meant to be isolated. By truly listening to your spouse can help connect you two, and help him/her feel less isolated. When you get the person out of isolation, you beat 50% of the mental illness’ game.

3) Identify MVP. In tech world, there’s something called MVP – Minimally Viable Product. In everyday household, there’s MVP too – Minimally Viable Process – core chores/processes that make the household function minimally. Identist the core tasks that make the household function and only focus on those. You two are going through some rough time now, and now is not the time to stress about the small stuff.

4) Identify which MVP each of you can handle. We understand, the dishes are piling up. Things can get overwhelming when one spouse is going through rough times. Identify what MVP each of you can handle, have a game plan, write it down, and break down tasks into small chunks. It’s much easier to handle it little by little.

5) ASK, “Are you thinking of killing yourself?” This is a hard question, I know. Many people wonder if asking this question would “encourage” the depressed person to kill him/herself. The answer is NO. If a person has a will to live, he/she wouldn’t comit suicide even if you ask that question. If a person is suicidal, that question can save a life. How you ask the question is key. When you feel nervous asking that question, your spouse would lie just to keep you calm. You need to keep calm and provide a safe space for the person to be forthcoming. Go to the mirror now, take a deep breath, and practice 100 times the question, “Are you thinking of killing yourself?” until you feel less nervous about it.

Get your partner to the hospital, and stay with him/her. Tell him/her that you really care that he/she is ok and that you will stay with him/her through this.

If you feel uneasy asking the question, see #6 below.

6) Call a mental health professional, please. A proper diagnosis and treatment would make a world of differences for your spouse and you (and the whole family). A qualified mental health professional will do suicide assessment, help with mapping out the unhealthy thoughts/feeling/behavior pattern, and strategize an action plan to disrupt that unhealthy pattern. Therapists at Women’s Therapy Institute are qualified mental health professionals that can help both of you get back on your feet.

You don’t need to do this alone when your spouse is suffering from mental illness. Give us a call. We work with men too.

Disclaimer: The articles in my blog are a matter of my opinion and perspective. They are meant to be educational only. Because they are general in nature, they should NOT be used as a substitute for getting qualified professional psychological, medical, or legal help should serious need arise. Please seek mental health or medical treatment from a qualified healthcare professionals.

My eyes wide open 2 minutes before my 6AM alarm goes off, and I swear my brain has already been churning out agenda of the day throughout the night – get breakfast ready, get the kids and their lunches ready, client appointments, review client progress notes, call the contractor, sign kids up for swim class, send expense to accountant, donate kids clothes, buy grocery and kids clothes from Costco, turn in kids school forms, talk to that web guy about SEO, make doctor appointment for kids booster shots, fix that scheduling bug on my website, get a sitter for Saturday night thingy, dinner, screw dinner, etc.

“Ok, it’s 5:58 AM! Wakey wakey,” says my brain. I turn around to see my snoring husband, I give him a stink eye and mutter, “You have no idea what I am going through!”

This is what feminists called, “mental load”. It is when a woman keeps mental track of all these things she has to do, the tasks that men do not think about and anticipate, and therefore do not help with unless they are being asked. This creates stress for many women, and tension for many couples. French comic artist Emma succinctly illustrated how women bear this “mental load” and that men should be more in tuned with women’s needs in her post “You Should Have Asked”.

I Agree To Disagree

In Emma’s comic, the wife is busy feeding kids and food boils over. The husband said, “you should’ve asked”. Emma stresses that men need to anticipate the household needs and women shouldn’t have to ask because when a woman asks, it puts her as manager and the man as subordinate. While I find Emma’s comic entertaining, I do not agree with that message.

I agree that men should not be passive bystanders when it comes to shared duties, but I don’t think men should anticipate all the needs without women communicating because some tasks are very obvious that the women need help and some are not obvious at all.

Once, I put all the clean clothes in a hamper and placed it near my husband’s side of the bed without instructions. He knew those are clean because he participated in the folding and yet he did nothing. After 3 days I asked him why he didn’t put the clean clothes away. He said he would have if I had asked. I asked why he needed me to ask and he simply said, “I don’t know what your plan is. Maybe you are putting the winter clothes away; maybe you plan to donate some of them. I can’t read your mind.” I then asked him, “Couldn’t you ask me what I want to do with it?” He replied, “I could. I suppose we both can step it up on this communication game when things are not so cut and dry.”

Touché.

Things Aren’t So Obvious

In the case of Emma’s comic, there’s no way for the husband to know if she is intending for the pot to boil until it’s too late. Only obvious or routine needs can be anticipated. If the family is leaving the house and he notices something is boiling on the stove, it makes sense for him to turn off the stove without asking. That’s obvious because it’s basic safety.

If Tuesday night is garbage day and she is not home in time to take care of it, it makes sense for him to take out the garbage without prompt because garbage day is routine and predictable.

For things that are not obvious or routine, two-way communication is essential. We really shouldn’t expect our partners to be mind readers and we need to communicate with each other.

It’s Not The What But The How

Communicating needs does not make one a manager and the other a subordinate but how you communicate those needs sets the tone of roles. If you bark your orders with your arms crossed, it might look like manager-subordinate roles and does not convey equilateral relationship. In communications, it’s not what you communicate but it’s how you communicate, verbally and non-verbally. There’s are always effective ways to communicate your needs without leaving a sour taste in everyone’s mouth.

If she finds a pile of dishes in the sink that she wishes he had done, she has three options: 1) yell at him about why he hasn’t done the dishes; 2) begrudgingly do the dishes while building resentment; 3) ask him to do the dishes while you do the things you intended on doing if he had done the dishes, and ask him to do it next time if he is the first on the scene of the dirty dishes. Some communications, verbal, text, even a post-it note is better than no communication. Chances are he will need to be reminded a few times before he makes this into a habit but it might be a better option than 1 and 2.

In the case of the husband in Emma’s comic, he could use a better communication tactic as well. Instead of asking his wife, “What did you do?” in an accusatory tone when the pot boiled over which aggravated his wife, he could say, “What happened? How can I help?” Remember, it’s not what you communicate, it’s how you communicate.

It’s 6:01 AM, my therapist brain finally wakes up. I look at my snoring husband again and remind myself that I shouldn’t expect him to be a mind reader. I walk over to his side, gave him a gentle kiss, and put a hamper of fresh clean clothes on the floor next to him with a note “Please put us away”, and go about my day.

Recently my newly-wed friend asked me what does equal partnership in marriage means, and does equal partnership mean splitting everything down 50-50 like Lena and Harold bickering over who should pay for the cat’s flea treatment in the classic movie The Joy Luck Club?

Most people see marriage as a “equal partnership” where each party brings their own contributions to the table. You will often hear things like: “If I have to pay the bills, then she will have to the chores”, “We both have demanding jobs so we decided that I pick up Johnny from school on Monday and Tuesday, then my husband does the remainder of the week”, or “We both have a savings target of $1000 every month, I contribute $500 and he does the other half.

HOW SHOULD MARRIAGE LOOK LIKE?

While there is nothing wrong with splitting chores and savings target, trying to achieve an equal balance is what is actually the recipe for disaster. Marriage is most healthy when it’s a union, not a partnership. In a partnership, your say depends on how much you are bringing to the table and their still the retaining of individual identities. But in a union, you both have a common purpose, therefore it doesn’t matter who is doing so much in an area or who is doing less. What your spouse doesn’t make up for in chores, they might make up for it in taking care of the kids or the bills. Partnership belongs in a law firm, not in a marriage.

50-50 IS EXHAUSTING

In a happy marriage, the key is giving 100% and being 100% helpful to your spouse according to the result of a survey carried out by the research team of Cornell University in the Legacy Project. This is something that I have also found to be true observing many couples in my therapy practice. When you decide to splitting hair on everything, you open yourself to exhaustion and frustration. Keeping tabs on how your partner hasn’t met you halfway is calculating and most likely leads to negative feelings of distrust. Constantly keeping tabs will only make create a feeling of resentment on both sides, which may transform a hairline into a fault line that will eventually break the marriage.

WHAT TO DO?

If a healthy relationship is the relationship goal, then both parties need to step it up and strive to be complimentary to one another. Even though every couple should have a mutual agreement of their duties and responsibilities, an attempt at creating a straight down 50-50 equality is not productive. You are both collectively responsible for the tasks that comes with your marriage and should both give a 100% all the time. Also, be fluid without being transactional. Don’t create a hard context. If something happens and the other person isn’t able to do their tasks any longer, recalibrate, and think about a new solution that will both work for you without trying too hard to get a 50-50 situation.
Marriage is sweet and messy. It is not clear cut and lines are blurry. You will have to take on loads on your plate at times. But with commitment, empathy, deep breathing and forgiveness, your marriage will not only work, but will be sweet and full of good memories.

Often times after an emotional divorce a contentious, sometimes brutal, custody disagreement ensues. When it comes to their children, parents become fierce. They love their kids more than anything and don’t want to lose any time with them, so they fight. They fight with their former spouse. They demand their children to pick sides. Suddenly. love becomes an extremely destructive energy.

In an effort to get as much time as possible with their children they forget about the quality of time. The children are placed in the middle, feeling the pull from both sides. They want to be fair to both parents, and they identify with both. Both parents are part of them and they don’t want to let either down.

When the children become witness to their parents’ battles or are part of negative conversations surrounding the other parent, harm is done. Hearing one parent bash the other becomes an internal struggle for the child and causes them to form negative views about either or both parents.

Children always remember these bad, contentious moments. Hostility, even when it’s towards the other parent and not directly at the child, diminish child’s trust. A child cannot trust the hostile parent’s ability to provide emotional safety. In the end, the child may resent the hostile parent and may remain emotionally distant from that parent, even when they still love that parent. I have many child and teen clients who tell me how they can’t wait to leave their hostile parent or the parent who forces them to choose sides. They still love their parents but want to get away from the fighting, the hostility. They want to escape the drama.

A wise person once told me that 90% of our time with our children is when they are between the ages of 0-18 before they launch into adulthood (that is assuming they don’t boomerang back home as an adult due to the economy, but that’s another topic). Parents who are fighting for custody tend to lose sight of this special time with their kids. They waste the last few teenage years by focusing on the quantity and not quality, when they are still in their care, and pull their kids into the fight. Parents often make the teenager choose between one parent or the other, continuing the hostility. They forget how important this time is with their kids. They forget to focus on building harmony and strengthening their relationship with their child. Sure, not all moments are hostile or negative, but every moment counts.

Children will eventually grow up and all custody battles will eventually end. I often ask parents what kind of relationship they hope to have with their child when their child becomes adult. Think about it, isn’t it sad that we spend all this time fighting for our children and we lose them in the process? Shouldn’t we be working to build harmony, for their sake and our future with them?

Sandra gets home from work and finds her husband bathing their toddler. She marches up to him and said, “You’ve got water all over the floor! Stop! Let me do this!” Her husband fires back, “Fine!”

Traditionally childrearing is considered a woman’s job but the world is changing. Today women are excelling in education, succeeding in careers and entering into relationships holding their own weight. Men are also stepping outside of their social gender role, and are 3x more involved in their children’s lives compared to their father’s generation. Most mothers rejoice over this trend, yet a good 21% consciously or unconsciously engage in “maternal gatekeeping” that may dissuade fathers from taking on more childcare tasks.

Whether due to natural instinct or societal expectations, many mothers identify themselves as the primary caretaker of their children and hold this value dearly. Maternal gatekeeping happens when mothers believe fathers are not as competent in the caretaking tasks due to the same set of societal expectations, and behave in a way that discourages the fathers’ effort, thereby obstructing collaborative parenting.

It is understandable that mothers want to do what’s best for the children. We need a small dose of maternal gatekeeping to keep us parents organized and get things done, but too much of it can hinder father-child bonding and affect couples relationships. Having it keeps mothers overwhelmed and experience maternal burnout. Raising children is a tough job and mothers need support, especially those who are working outside of home. More men are willing to step in nowadays so moms, you can allow yourself some rest. You deserve less stress.

How to prevent yourself from being a “Maternal Gatekeeper”?

Notice it – Sometimes our maternal instinct is so ingrained that we don’t even notice we are being the “gatekeeper.” Having an awareness of our behavior can help us make conscious decisions as parents.

Let go of high standards – Your partner has his own style of parenting. It’s unrealistic to expect your partner to do everything within your standards.

Focus on the big picture – Your kids will not remember the water splashing on the floor, but they will remember the fun times when their daddy made silly soapy hairstyles for them. (If the kids are old enough, you can coach daddy to have them clean up the mess together.)

Communication sandwich — If you need to communicate with your partner on how he can do things differently, consider talking to him after the fact when you two are in a good mood, and use two compliments to buffer one criticism.

Talk to a professional — Therapy can help you gain some relaxation skills so you can be happy even with soapy water on the floor.

Mark Zuckerberg announced on Friday that he and his wife Priscilla Chan are having a baby girl. In the midst of the happy announcement, he spoke of the emotional pain of suffering three previous miscarriages.

Zuckerberg candidly talked about the loneliness that he and his wife endured during the pregnancy.

“Most people don’t discuss miscarriages because you worry your problems will distance you or reflect upon you — as if you’re defective or did something to cause this, so you struggle on your own.” wrote Zuckerberg on his Facebook post.

Thank you, Mark Zuckerberg for bringing attention to the issue of grief and loss accompanied by miscarriage. His high-profile post creates safety for others to share their stories and in turn reduced the stigma of pregnancy loss.

According to the American College of Obstetricians and Gynecologists, 10-25% of all pregnancies will end in miscarriage. 50-75% of all miscarriages are chemical miscarriages (early stage of pregnancy before it can be detected by ultrasound).

Miscarriage is traumatic. I know this on a personal level because I too have had a miscarriage. Most women undergo the feelings of grief and loss after a miscarriage. It’s well-documented that women who have experienced pregnancy loss can also get “postpartum depression”. According to the Journal of the American Medical Association, about 11 percent of women who had a miscarriage suffered from major depression following the event. There is no doubt that women who have experienced pregnancy loss need additional support from family, friends and medical community.

Since miscarriage is common and the emotional consequence is serious, why aren’t we talking more about it openly? Stigma – miscarriage is a taboo topic for many people. Many people are not comfortable hearing about it. Most do not know how to respond when someone tells them about miscarriage, and therefore we don’t want to burden our loved ones with the sad news when we experience the loss.

Another reason we don’t talk about miscarriage is that traditionally it is thought of as a “woman issue.” Society holds women responsible for everything related to child birth. When a woman experiences a miscarriage, our society doles out implicit blame that it’s somehow the mother’s fault. Women internalize this message, and may subconsciously blame themselves for the loss. Why would women speak up when we are the blame for the misfortune? Why would men listen when it’s thought of as a “woman issue”? It may sound sexist, but it’s also a reality.

Mark Zuckerberg’s post brings awareness to four things; 1) miscarriages happen often, 2) miscarriage is emotionally painful, 3) this emotional pain affects both men and women and 4) we need to talk about it. Throughout times women talk among themselves about the pain of miscarriage, but there can’t be meaningful discussions and true compassion for this frequent pain until more men join in the conversation. And I am glad we are heading to the right direction.

I recently came across an article on PopSugar called “Should You Teach Your Kids to Share”. In the article, author Beth W articulates that she doesn’t teach her son to share because the act of sharing teaches children 1) that they can have something that belongs to someone else, and 2) that they can act without regards of others. While I think Beth W has some good points, her article only shows one side of the story…Let me show the other side.

The Evolution of Sharing

From an evolutionary standpoint, the prosocial act of sharing and cooperation has helped various species survive throughout times. Human beings are social animals; we share food, resources, and knowledge for support and protection. If the caveperson who discovered fire didn’t share the knowledge, the human race would probably have died from cold weather or food-borne diseases.

Sharing in the Modern Times

In our modern world, sharing is equally important. Until we solve the problem of inequality and poverty, many charities and activists still need donations from the “haves” to help the “have nots”. When we teach kids not to share, teaching them that helping those in need is not important.

Sharing is also crucial to our cultural growth. For centuries, we have been sharing ideas and knowledge so that our arts can be more vibrant and our technology can be more advanced. If our kids guard their ideas so tightly, they will inadvertently limit their own world.

Sharing in the Work Place

On a micro-level standpoint, sharing is an essential part of our day-to-day work life. I am a therapist in a community health agency, and everyday my colleagues and I rely on each other’s support to provide good care to our clients. Often times I need to leverage resources from another department to help my clients. I don’t speak Spanish, and it would be difficult for me to work with a Spanish-speaking client if I cannot “borrow” a Spanish translator from another department.

What to Teach Kids About Sharing

I agree with Beth W’s article that there are downsides to sharing, but teaching kids not to share has its pitfalls. So how should we teach our kids about sharing? I believe the process needs to be fluid because I don’t think the all-or-nothing approach works well in our dynamic world. We will need to set some guidelines about sharing when it comes to our own belongings and public belongings (ie. school, parks and rec centers). We can teach our kids the positive aspect of sharing and encourage this prosocial behavior, while teaching them that they have a choice whether to share or not.

I believe we can teach our kids about coping with disappointment and making good choices in sharing at the same time.

Jessica is having trouble concentrating in her math class because she is getting very little sleep at night. She lies awake for hours worrying about why her best friend doesn’t talk to her anymore, whether everyone is looking at her funny, whether she will bomb the math test tomorrow, whether her parents are really going to divorce, and other catastrophic what-ifs.

Tara seems to have the “perfect” life with a home, career and children that she adores yet she feels overwhelmed. Now her things are not getting done and she doesn’t laugh as often anymore. She doesn’t sleep much and when she does, she often wakes up heart pounding and palms sweaty, thinking she is going crazy and fearing “her perfect life won’t last”.

From the time a girl reaches puberty until late adulthood, she is twice as likely to have anxiety as a man. While men are not immune to anxiety, men and women’s differences in brain chemistry and hormonal levels in different life stages may be pieces of the puzzle as to why women are more vulnerable to anxiety during stressful events.

If you or your daughter experiences anxiety, there are things to do about it.

Allowing Anxiety: Forcing yourself or your child not to worry or minimize the anxious feelings can create even more anxiety. It can be defeating when those worries just won’t go away. We need a healthy dose of worrying to keep us safe or get things done; it has a purpose so we don’t want to eliminate it completely. Since it serves a function, it’s important to take anxiety seriously and allow it’s existence so we can shift it to our benefits.

Relaxation Skills: Breathing and visualization helps you calm down when you are agitated. Relaxation techniques need to be age-appropriate and don’t have to be boring. Some can even be done while you are in the middle of a task. For teens, there are apps such as Breathe that can help.

Movement: It’s understandable that when you are anxious, the last you want to do is to get out of bed. It may seem cumbersome but setting a goal to do something as simple as walking around the block can work wonders. Sometimes staying indoor with the blinds closed may affect your circadian rhythm (aka. body clock), which can disrupted your sleeping pattern. Going outside and getting some sun and air can help “reset” your body clock so you can sleep better at night, feel more refreshed the next day, and have better mood.

Talk to a licensed therapist who is in tuned with teen and women’s issues, and values whole-health approach. A good therapist is able to listen, teach relaxation techniques, and tailor a therapeutic plan that best fits you. The first session is usually paperwork and getting to know each other, so give it a few sessions before deciding whether the therapist is right for you.

While nobody’s life is completely worry-free, but anxiety can be manageable and it doesn’t have to control your whole life. You don’t need to do this alone.